Stories of patients

Vitaly Evgenjevich born in 1962
(personal information was changed)
Treating in Onco.Rehab clinic since June, 2020
Treating doctor Vladimir V. .
BI of the left kidney T3N0M1 (OSS), Stage IV, mts to the right thigh, seventh rib to the left. Mts to the lungs.

Condition after left cytoreductive nephrectomy dated 08.2019. Condition during therapy with sunitinib since September, 2019.

Complications: pathological break of the right femur dated 09.08.2019. Condition after surgical treatment dated 30.08.2019 (closed repository, immobilization of the break of the right femur with the bone fixation apparatus). Condition during the therapy (sunitinib 50 mg daily + denosumab 120 mg s/c for 28 days + photodynamic therapy since 05.06.2020). Second clinic group. ICD-10 C64

Histological screening: surgical sample (kidney) (689403), No.6207 dated 09.08.2019. Result – clear cell renal cell carcinoma of kidney, G4, grows though the capsule, paraaortic lymph nodes without tumour. Radioisotope research: whole body osteoscintigraphy dated 16.07.2019. Whole body cintigrams in rear and front projections show intensive inclusion of the medication into bone structures. Distribution of the radiopharmaceutical corresponds to the age norm. Foci on intensive pathological hyperfixation of the radiopharmaceutical are remarkable in the projection of the front part of the seventh right rib, middle and upper third of diaphysis of the right femur. In other bones distinct foci of pathological accumulations of the radiopharmaceutical, which are typical for the specific pathological process, were not reliably revealed. Distribution of the radiopharmaceutical in the parenchyma of the left kidney is focally uneven. Taking into account the information from the anamnesis – left kidney C-r. Residual radioactivity in the right kidney and the urinary tract corresponds to the time of the scanning. Atypical fixation of the medicine in parenchymal organs and soft tissues is absent.

Conclusion: scintigraphical signs of the secondary damage of the front part of the seventh right rib, right femur. MSCT of abdominal, chest organs and organs of retroperitoneal space with i/v contrast dated 16.07.2019.

Conclusion: MTS in the seventh right rib. Mts in S8S10 lower part of the left lung and in S4 middle part of the right lung. Small single subpleural foci in both lungs. Chronic deforming bronchitis. Bilateral basal and apical pneumosclerosis. Post-inflammatory changes in the upper segment of the left lung. Malignant formation in the left kidney. Simple cysts of the left kidney. Single simple cysts of the right part of the liver. Chronic cholecystopancreatitis. MSCT of chest organs with i/v contrast dated 09.01.2020.

Conclusion: Multiple mts of both lungs. Positive dynamics in comparison with the data from previous CT (decrease of the sizes of lung foci. New mts at the screening were not found). Condition after the resection of the part of the seventh right rib. The patient had a consultation in SBHOVR “Regional Clinical Oncology Hospital” in Vladimir.

Recommended therapy: sunitinib 50 mg daily for 4 weeks/2 weeks with the break till progression or votrient 800 mg daily till progression + denosumab 120 mg s/c daily for 12 months. The patient does not get medications within AMS and RMS.

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Medical commission took place. There was taken a decision to choose the treatment (sunitinib 50 mg daily for 4 weeks/2 weeks with the break till progression; denosumab 120 mg s/c daily for 12 months). CT of chest organs with i/v bolus contrast dated 04.08.2020.

Conclusion: Focal changes (mts) of both lungs dated 15.05.2020. – without negative dynamics, some decrease of foci sizes in C8 of the left lung is noticeable, new foci are not revealed. Osteolytic mts in the front part of the seventh right rib (without visible dynamics since 15.05.2020). Chronic deforming bronchitis. Fibrous changes in C1/2 of the left lung. S-shaped scoliosis of the spine at the screening. Radioisotope screening: whole body osteoscintigraphy dated 18.09.2020. Intensive inclusion of the medicine into bone structures is seen in the front and rear projections in the scintigrams of the whole body. Radiopharfaceutical distribution corresponds to the age norm. The patient is at the monitoring since 2019, the second screening in total. Comparing with the previous scanning dated 16.07.2019 – scintigraphic image of the radiopharfaceutical distribution has positive dynamics: inclusion of medicine in previously revealed centres decreased (in the projection of the front part of the seventh right rib, right femur). New foci were not reliably revealed. The single functioning kidney is visualized. Residual radioactivity in the kidney corresponds to the time of the scanning. Atypical fixation of the medicine in parenchymal organs and soft tissues is absent. Ultrasound of kidneys, the bladder, prostate dated 21.01.2021.

Conclusion: ECHO-image after left-sided nephrectomy. Ultrasound on abdominal organs dated 27.01.2021г.

Conclusion: ECHO-image of calculous cholecystitis.

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1
number of
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number of
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240 months
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